Document Detail

Ambulatory 24-hour colonic manometry in slow-transit constipation.
MedLine Citation:
PMID:  15571589     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The colonic neuromuscular dysfunction in patients with constipation and the role of colonic manometry is incompletely understood. AIM: To study prolonged colonic motility and assess its clinical significance. METHODS: Twenty-four-hour ambulatory colonic manometry was performed in 21 patients with slow-transit constipation and 20 healthy controls by placing a 6-sensor solid-state probe up to the hepatic flexure. Quantitative and qualitative manometric analysis was performed in 8-h epochs. Patients were followed up for 1 yr. RESULTS: Constipated patients showed fewer pressure waves and lower area under the curve (p < 0.05) than controls during daytime, but not at night. Colonic motility induced by waking or meal was decreased (p < 0.05) in patients. High-amplitude propagating contractions (HAPCs) occurred in 43% of patients compared to 100% of controls and with lower incidence (1.7 vs 10.1, p < 0.001) and propagation velocity (p < 0.04). Manometric features suggestive of colonic neuropathy were seen in 10, myopathy in 5, and normal profiles in 4 patients. Seven patients with colonic neuropathy underwent colectomy with improvement. The rest were managed conservatively with 50% improvement at 1 yr. CONCLUSIONS: Patients with slow-transit constipation exhibited either normal or decreased pressure activity with manometric features suggestive of colonic neuropathy or myopathy as evidenced by absent HAPC or attenuated colonic responses to meals and waking. In refractory patients, colonic manometry may be useful in characterizing the underlying pathophysiology and in guiding therapy.
Satish S C Rao; Pooyan Sadeghi; Jennifer Beaty; Renae Kavlock
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  99     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-01     Completed Date:  2005-02-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2405-16     Citation Subset:  IM    
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
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MeSH Terms
Analysis of Variance
Area Under Curve
Case-Control Studies
Colon / physiopathology*
Constipation / physiopathology*
Gastrointestinal Motility / physiology
Manometry / methods*
Middle Aged
Monitoring, Ambulatory
Statistics, Nonparametric
Grant Support

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